MEDICARE: DR. ROY L SAENZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G53517	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CLR00301307	OTHER	CA	CLIA NUMBER

General Provider Information

NPI Number	:	1831195221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY L SAENZ MD

Provider Business Mailing Address
First Line	:	931 BUENA VISTA ST STE 205
Second Line	:	STE 205
City	:	DUARTE
State	:	CA
Zip	:	91010-1713
Country	:	US
Telephone Number	:	626-358-1897
Fax Number	:	626-301-0937

Provider Business Practice Location Address
First Line	:	931 BUENA VISTA ST
Second Line	:	STE 205
City	:	DUARTE
State	:	CA
Zip	:	91010-1713
Country	:	US
Telephone Number	:	626-358-1897
Fax Number	:	626-301-0937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	11/27/2012

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